Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography.

Beattie, R. B.; Dornan, James

doi:10.1136/bmj.298.6674.631

Cited by 100 publications

(10 citation statements)

References 19 publications

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“…Out of 50 patients with abnormal umbilical artery Doppler, 15 patients had IUGR births with a sensitivity of 25% and 42.86% for S/D ratio and RI, respectively. It is similar to opinion by Antsaklis et al 11 and Beattie et al 15 Romero et al 16 studied 43 women, and among them, 52% had abnormal umbilical Doppler. They found that abnormal umbilical Doppler is associated with lower birth weight, lower Apgar score, and significant neonatal morbidity.…”

Section: Discussionsupporting

confidence: 82%

The Role of Uterine and Umbilical Arterial Doppler in High-risk Pregnancy: A Prospective Observational Study from India

Nagar

Sharma

Choudhary

et al. 2015

Clin Med�Insights�Reprod�Health

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AIMTo study the role of Doppler imaging in prediction of high-risk pregnancies and their outcomes.METHODS AND MATERIALThis prospective study in a setup of tertiary-level care center includes 500 high-risk pregnant women from rural and urban sectors and evaluates the predictive values of various Doppler indices.RESULTSOut of 500 patients, 110 patients had abnormal Doppler among them, 70 patients had abnormal uterine artery Doppler, and 50 patients had abnormal umbilical artery Doppler flow indices. In all, 10 patients had both umbilical artery and uterine artery abnormal Doppler indices. When uterine artery was abnormal (70 patients), 20 patients had preeclampsia, 10 patients had pregnancy-induced hypertension (PIH), and 25 patients had intrauterine growth restriction (IUGR). Systolic/diastolic (S/D) ratio and notch had sensitivity of 60% and positive predictive value of 33.3% and 37.5%, respectively. When umbilical artery was abnormal (50 patients), 10 had preeclampsia, 15 had PIH, and 15 had IUGR. S/D ratio had the highest positive predictive value of 40%; sensitivity is same for all. In uterine artery, combination of parameters had the best sensitivity of 80%, followed by notch and S/D ratio. In umbilical artery, combination of parameters, S/D ratio, and RI (resistance index) had sensitivity of 40%; specificity of all the indices was 91–96%. In all, 20 patients had bilateral notch, and among them 15 developed preeclampsia and 15 developed IUGR. When both uterine and umbilical artery Doppler were abnormal (10 patients), all patients had preeclampsia and IUGR.CONCLUSIONTherefore, Doppler study may be used for the prediction of preeclampsia and IUGR to reduce the maternal and perinatal morbidity and mortality.

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Section: Discussionsupporting

confidence: 82%

The Role of Uterine and Umbilical Arterial Doppler in High-risk Pregnancy: A Prospective Observational Study from India

Nagar

Sharma

Choudhary

et al. 2015

Clin Med�Insights�Reprod�Health

View full text Add to dashboard Cite

show abstract

“…Many studies 20 - 23 addressing the clinical value of umbilical artery velocimetry have emphasized the ability of this technique (or lack thereof) to determine fetal weight. However, it should be stressed that umbilical artery Doppler velocimetry is a method for determining distance impedance to blood flow rather than a technique designed to measure fetal size.…”

Section: Discussionmentioning

confidence: 99%

Is An Abnormal Doppler Umbilical Artery Waveform Ratio A Risk Factor for Poor Perinatal Outcome in the Non-Small for Gestational Age Fetus?

Yoon¹,

Oh²,

Pr³

et al. 2008

Amer J Perinatol

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To determine if abnormal umbilical artery velocimetry is associated with a higher rate of perinatal morbidity in pregnancies in which the outcome is not manifested by a small for gestational age (SGA) fetus, perinatal outcome was compared according to the results of Doppler umbilical artery velocimetry. Doppler study was performed in 328 singleton pregnancies with non-SGA fetuses within 7 days of delivery. The prevalence of abnormal Doppler studies was 10%. Patients with abnormal umbilical artery velocimetry had a significantly higher rate of complications, including cesarean section for fetal distress, preterm delivery, low Apgar scores, congenital anomalies, admission to the neonatal intensive care unit, and perinatal death, than patients with a normal umbilical artery velocimetry. Ten perinatal deaths were associated with major congenital anomalies. Moreover, in the absence of congenital anomalies patients with abnormal Doppler results also had a significantly higher incidence of adverse perinatal outcome compared with patients with normal umbilical artery velocimetry. Our data suggest that even the non-SGA fetus with an abnormal Doppler umbilical artery waveform ratio is at increased risk for poor perinatal outcome.

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“…[ 1 ] In addition, IUGR is also associated with prematurity, low Apgar scores and foetal distress. [ 2 ] Hence, antenatal surveillance for foetal biophysical profile and intensive intrapartum monitoring for better neonatal outcome is recommended in these pregnancies. [ 3 ] It has been shown in various studies that by sympathectomy, epidural analgesia reduces uterine and umbilical arterial vascular resistance and therefore improves uteroplacental blood flow.…”

Section: Introductionmentioning

confidence: 99%

Maternal and foetal outcome after epidural labour analgesia in high-risk pregnancies

et al. 2016

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Background and Aims:Low concentration local anaesthetic improves uteroplacental blood flow in antenatal period and during labour in preeclampsia. We compared neonatal outcome after epidural ropivacaine plus fentanyl with intramuscular tramadol analgesia during labour in high-risk parturients with intrauterine growth restriction of mixed aetiology.Methods:Forty-eight parturients with sonographic evidence of foetal weight <1.5 kg were enrolled in this non-randomized, double-blinded prospective study. The epidural (E) group received 0.15% ropivacaine 10 ml with 30 μg fentanyl incremental bolus followed by 7–15 ml 0.1% ropivacaine with 2 μg/ml fentanyl in continuous infusion titrated until visual analogue scale was three. Tramadol (T) group received intramuscular tramadol 1 mg/kg as bolus as well as maintenance 4–6 hourly. Neonatal outcomes were measured with cord blood base deficit, pH, ionised calcium, sugar and Apgar score after delivery. Maternal satisfaction was also assessed by four point subjective score.Results:Baseline maternal demographics and neonatal birth weight were comparable. Neonatal cord blood pH, base deficit, sugar, and ionised calcium levels were significantly improved in the epidural group in comparison to the tramadol group. Maternal satisfaction (P = 0.0001) regarding labour analgesia in epidural group was expressed as excellent by 48%, good by 52% whereas it was fair in 75% and poor in 25% in the tramadol group. Better haemodynamic and pain scores were reported in the epidural group.Conclusion:Epidural labour analgesia with low concentration local anaesthetic is associated with less neonatal cord blood acidaemia, better sugar and ionised calcium levels. The analgesic efficacy and maternal satisfaction are also better with epidural labour analgesia.

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Antenatal screening for intrauterine growth retardation with umbilical artery Doppler ultrasonography.

Cited by 100 publications

References 19 publications

The Role of Uterine and Umbilical Arterial Doppler in High-risk Pregnancy: A Prospective Observational Study from India

The Role of Uterine and Umbilical Arterial Doppler in High-risk Pregnancy: A Prospective Observational Study from India

Is An Abnormal Doppler Umbilical Artery Waveform Ratio A Risk Factor for Poor Perinatal Outcome in the Non-Small for Gestational Age Fetus?

Maternal and foetal outcome after epidural labour analgesia in high-risk pregnancies

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